Monday, June 7, 2010

Medical Mondays: The Secret Blood Club

She asks, "Is there a blood type/quality/whatever that would make it very difficult to find a donor? Is it possible they could do this transfusion right there locally, from one student to another?"

There are 30 ways to type blood, but the most important, for the sake of transfusion, is the ABO and Rh (+ or -) typing. There are eight blood types (see cartoon above) based on the special proteins found on the surface of the blood cells and the antibodies we make.

You can't just give blood willy-nilly (who the heck is Willy Nilly?) from one person to another. We carry antibodies to people with different types. In fact, some mothers carry antibodies to their own baby's blood types and must receive a special injection just before giving birth or the baby's blood will get attacked by the mom's antibodies during birth.

To make a long, long lesson in blood typing short, here are a few important factoids:

AB+ blood are universal recipients. So all eight groups above can give blood to this type of person. They are 3.5% of the US population.

O- are universal donors. This blood can be given to any of the eight above without causing a reaction. O- are about 6.6% of the population.

AB- is the rarest blood type. Only 0.6% of the population have this. However, they can receive blood from A-, B-, AB-, or O- people.

So to answer Susan's question? She needs a recipient AND a donor that are relatively rare. In the end, the best answer was that both characters needed to be O-.

As for Susan's second question? In the modern world, there are no direct person-to-person transfusions anymore. It's simply unheard of now (the last time I saw it was in the movie Bram Stoker's Dracula). Blood must be tested for all kinds of diseased first, like HIV, hepatitis, among others, and blood must be tested for compatibility first.

But in a small town that's searching for a difficult blood type, it's easy to imagine that the blood bank lab could "slip" the identity of the donor to the recipient. And these days, people do bank blood for themselves or family members to plan for surgery.

Okay, on last thing. I get asked this all the time during my day job. Can you ask your doctor to figure out what blood type you are, just in case?

Answer? Not unless you want to pay out of pocket for it. Docs only check blood type for two reasons: when they expect to transfuse you (before surgery, or during a bad illness), or when you are pregnant, to plan for the possibility of incompatible Rh factors. And of course, you can donate blood to find out!

So if you really want to know, and you've already had a baby, your OB's office will probably have that on record. For the rest of you, you'd have to wait until (gulp) you needed surgery or (bigger gulp) you were in some sort of trauma or succumbed to an illness that caused a terrible anemia. Or if you qualify, donate blood!

Please keep in mind this post is for writing purposes only and is not to be construed as medical advice!

I do have a question and I don't know if I've already asked you or not...

Is there any other kind of disease that could be misconstrued as Alzheimer's? (There used to be a commercial on television a few years back about some form of vitamin deficiency in old people that presented almost the same symptoms.) And if there is such a disease, is there a magic pill that will take care of it (the commercial proposed one). My character has the signs of Alzheimer's but I don't really want her to have it, I want her to be curable. Is that possible? Thanks Lydia.

Thanks for the inside info. When a family member was undergoing heart surgery years ago, several family members offered to donate blood, but it was too late to do so. With all the testing and precautions that are so necessary, now I can see why!

Crazy! I had a scene (that got the boot) in an early version of my MS where a character needed a blood transfusion and I needed that rare blood type and did the research and came up with two different answers AB- and O-. Small world, and I love the medical post. My husband is a field "medic" and he's always trying to give me IV's when I dont need them lol. The scene is no longer in the MS but should it come up that a character needs to live, I'll be sure to remember its O- :)

Awesome post! I just received feedback on a part in my WIP about brain damage from my friend currently working on her doctorate in psychology. She said, "it reads like it was written by someone who doesn't know what they're talking about." But then she told me how to fix it, so it was all good. Thanks for the great advice!

Great post, Lydia. For some reason, my blood type is on my birth certificate. I don't know if that was typical back in 1970, or if it was just that hospital. I know it's not on Daughter's certificate. In 6th grade, my teacher had us type our own blood. I knew mine was A+, but she said it was B+. (Which kind of ticked my dad off - since he's A+ and mom is O+. LOL)

Great information! I never really understood how the types were determined, so this really helps. And wow about the percentages! I'm going to have to dig out my old Red Cross donor card to remember what type I am!

I used to not know my blood type, until I lay on a table waiting to be put under for an emergency procedure. The doctor asked me my blood type in case something happened. I had to admit I didn't know. "That's okay, we'll check," was the reply just before I fell asleep. My last thought? "I hope they check."

That was fascinating. Thank you, Lydia.I have a question for you. One of my characters has fractured a rib and has a contusion on her lung. She is taken to ER where she is scanned.Can you tell me what the ER doctor would do first? Feel the area? X-ray and then follow with CT? Once it's determined she is in danger of respiratory distress, would she be put in ICU? And what would they do to a semi-conscious, weak person with such an injury--oxygen, IV, any thing else?Thanks in advance for putting my question in your Monday lineup. :D

You are so generous of your time and expertise to answer these questions! Very interesting lesson on blood type!My whole life my mom said I was O+ and my sister was A+. But when I gave birth, I was told I was A+! Whoops! Good thing they check, but hopefully I will never need a reason to need blood. I do try to give blood a few times a year.

Hey Lyda, thanks for following my blog--great to meet you and now I'm following you. OMG, this is the coolest blog ever! I LOVE IT! I lived with like 8 pre-med students in college and now that they're in med school I harass them all the time to answer weird medical questions for my novel which has a lot of fighting and injuries. I am SO glad I found your blog!!

Lydia--It's so nice to have an expert among us...I'm A-, what's funny is I've discovered that several of my friends are too...I'm sure I'm going to have some mental health questions when I finish my mg hf novel and get back to my ya...Thanks for answering Susan't questions. :)

Informative post. I am RH negative and I never really understood what this meant until my first pregnancy. I was on berets with triplets in the hospital for weeks and I remember having to receive an injection like the one you described. The doc said I had to have an immediate "rogan" (i am sure this is not spelled correctly). I started laughing because I though he meant rogaine, the chemical to stimulate mens hair growth.

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